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Assisted-living facilities now must be licensed

February 17, 2002|By Jane Adler. Special to the Tribune.

You might be surprised to learn that assisted-living facilities have been largely unregulated by the State of Illinois. That doesn't necessarily mean residents have been receiving bad care, but it does mean these private facilities have been operating without a consistent set of rules and procedures to follow.

That's about to change. New rules that govern assisted-living facilities in Illinois are being set in place. The rules should give consumers at least a little help in figuring out exactly what it is they are buying. Ask anyone who's shopping for an assisted-living, long-term-care home. It can be very confusing to sort through all the options available nowadays.

"The new rules set some standards that were not there before," says Kelly Cunningham, who oversees the relatively new Bureau of Assisted Living at the Illinois Department of Public Health in Springfield. "Consumers will know what they are buying."

The Assisted Living and Shared Housing Act, which took effect about a year ago, requires assisted-living facilities to obtain a license to operate.

Since the law went into effect, regulators and industry representatives have been hammering out the rules that assisted-living facilities must follow in order to get a license. Those rules were finalized in December. Assisted-living facilities can now apply for a license.

For consumers, it's important to know that facilities won't be able to tout themselves as "assisted living" unless they have a license to operate as an assisted-living facility.

"When a facility advertises itself as assisted living, a consumer will know what service package the facility has to offer," explained Cunningham. In particular, a licensed assisted-living facility has to provide a service contract. The service contract should specify exactly what the facility will provide. It also should stipulate the cost of those services.

Another big change under the new law is that licensed facilities will legally be able to provide their residents with help, the big reason people move to an assisted-living facility in the first place. Previously, assisted-living facilities could not give their residents help with the so-called tasks of daily living, such as eating, dressing or bathing. Instead, an outside health care agency would provide the staff to handle these jobs. "The housing provider was not the direct provider of care," explains Jean Elliott, director of housing and assisted living at Hinsdale-based Life Services Network of Illinois, the industry group that represents Illinois senior health-care providers, including not-for-profit nursing homes. As you might expect, under this complicated system, there was an exception. Many facilities in Illinois that have been operating as assisted-living homes have a "sheltered care" license, the lowest level of nursing home designation. These places could provide direct care to residents. Under the new law, these homes can operate as assisted-living facilities, as long as they follow the new rules.

The new law requires licensed facilities to provide consumers with certain information about the place. This information includes a copy of the current resident handbook and policies. Facilities must have their license posted in public view. Also, the Illinois Department of Public Health will conduct annual inspections of the homes. The facility must make available the results of that review, or so-called survey.

Illinois is one of the last states to enact a law to cover assisted-living facilities. "This law has been in the making forever," noted Elliott at Life Services Network. But she considers the delay a blessing in disguise. She says regulators and industry representatives learned from the mistakes of other states that over-regulated the relatively new housing concept of assisted living. The Illinois law, Elliott said, gives consumers and providers some flexibility. For instance, the law doesn't specify the exact time meals must be served. Also, apartments must accommodate kitchen appliances. A big principle that governs assisted-living facilities, Elliott adds, is the concept of negotiated risk, which was preserved in the new law. The facility doesn't dictate what kind of care you get. For example, a resident can specify a bathing schedule, whereas a nursing home must follow certain rules. "Consumers have some control over the care they receive," Elliott said. "If we had enacted a law earlier, assisted-living facilities would look a lot more like nursing homes," she added.

So far, 18 applications for the assisted-living facility license have been received by the Illinois Department of Public Health, according to Cunningham. She expects about 120 facilities to apply for the license. Licenses probably won't be issued until summer.

Once licenses are issued, Cunningham will have a list available for consumers. The list eventually will be posted on the Web site of the Illinois Department of Public Health.